- Pediatric Neurocritical Care: From Field to Follow-up
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- Pediatric Neurocritical Care | SpringerLink
Pediatric Neurocritical Care: From Field to Follow-up
Back to Top. Overview Meet the Team News Contact. We treat a wide range of conditions, including: Traumatic brain injury Stroke Status epilepticus Patient who have had a cardiac arrest Sepsis Multi-organ system failure Shock Hypoxia and ischemic brain injuries Liver failure Spinal cord or peripheral nerve conditions Patients who have undergone neurosurgical procedures brain tumors, hydrocephalus, congenital anomalies, epilepsy surgery, spine surgery, etc. Pediatric care and the resources of Massachusetts General Hospital Pediatric Neuro-Critical Care at MassGeneral Hospital for Children combines the expertise of physicians board certified in Pediatric Critical Care Medicine, pediatric neurology and neuro-critical care with the neuroscience resources of Mass General.
Extensive experience in stroke and traumatic brain injury Mass General has a well-developed pediatric stroke program with extensive expertise in acute stroke management in older children and adolescents, strokes in neonates and infants, and brain imaging evaluation of stroke and cervico-cranial vascular disorders.
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Research specific to the needs of children Neuro-Critical care for children is different from adult neurocritical care and our research focuses on the unique needs of children. Other research includes: Monitoring for non-convulsive seizures in patients with traumatic brain injury Infection and stroke risk in pediatric patients Application of NIRS Near infrared spectroscopy monitoring for brain perfusion in critical illness Secondary mechanisms of acute brain injury including in trauma and intracerebral hemorrhage Cerebral malaria Blood brain barrier research Brain trauma — the TRACK TBI and ADAPT studies Auditory Brainstem Implant trial with Massachusetts Eye and Ear Institute — this is a trial of a new type of implanted device in the brain which is designed for children who have profound deafness to enable them to hear Our program is also participating in an international registry of pediatric stroke patients collecting data to help understand risk factors related to pediatric stroke.
Our neurocritical care research involves collaborative, multispecialty programs in basic science and clinical research that tap into the strengths of the Johns Hopkins neuroscience community. Because both injury and response to injury in the pediatric age group can be influenced by perinatal events and have effects at older ages, our program focuses on integrating the pathology throughout life, from the fetus to old age.
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View our phone directory or find a patient care location. All of the presentations highlighted important factors and predictors in the recovery process from critical illness. Pediatric neurocritical care has emerged as a subspecialty within both pediatric neurology and pediatric critical care over the last two decades.
Pediatric Neurocritical Care | SpringerLink
Over the preceding decade, adult neurocritical care formed "closed units" staffed by specialty trained neurologists and became a neurologic subspecialty with the formation of the United Council for Neurologic Subspecialties in In contrast, pediatric neurocritical care is unlikely to follow a similar path, as it is increasingly clear that pediatric neurocritical care requires equal contributions from critical care, neurosurgery and neurology.
For example, one of the most frequent presentations in pediatric neurocritical care is traumatic brain injury TBI , which is often in the context of polytrauma.
Similarly, cardiac arrest is almost never due to an isolated or pure neurologic cause and strokes may complicate broader infections or inflammatory processes. More importantly, though, is an increasing appreciation of the neurocognitive and psychosocial impacts of critical illness that are not limited to acute brain injury, making almost all patients in a pediatric intensive care unit potential "neurocritical" patients. Simultaneously, intensive care has continued to improve, decreasing patient mortality.
The heightened awareness of the neurocognitive and psychosocial morbidities of an ICU stay are particularly cogent in those with acute brain injury. Faye Silverstein demonstrated how a quantitative neurologic exam correlated with a patient's ability to adapt to, and cope with, environmental changes after cardiac arrest. Laura Lehman's data revealed that neuropsychological morbidities are not limited to the patient, as post-traumatic stress disorder PTSD was common in parents of children admitted to an ICU for stroke. Interestingly, PTSD symptoms did not directly correlate with severity of the child's stroke, and persisted for months after hospital discharge.
These talks illuminated how even "standard" neurology consultation in the ICU may benefit from a greater depth of neurology and neuropsychology assessment. Guerriero's talk, Traumatic Brain Injury: from field to follow-up emphasized the breadth and depth of care a neurologist can bring to critical care and rehabilitation in a collaborative, consultative role. Acute TBI, the quintessential pediatric neurocritical care condition, has traditionally been cared for, almost exclusively, by critical care physicians and neurosurgeons in the ICU.